2) This series is supported by an educational grant from AbbVie and is intended for #healthcare providers. Faculty disclosures are listed at https://t.co/WqtnjZHgh0. Previous #tweetorials, still available for CE/#CME credit, are at https://t.co/3Rt15X6pUA pic.twitter.com/1siqIXoWNm
— @migraine_ce (@migraine_ce) October 26, 2021
4) See Migraine community resources at #TeenTalks with @Miles4Migrainehttps://t.co/Ou7USFWvqD
— @migraine_ce (@migraine_ce) October 26, 2021
6) Chronic migraine is also common in kids: episodic – 9% of the children, Chronic in 0.6% (5-12 y of age) . Poor performance at school was significantly more likely in children with migraine, relative to children who does not have headaches https://t.co/RbOqnkk66M
— @migraine_ce (@migraine_ce) October 26, 2021
8) Recent study shows – Nonwhite children were less likely to receive medication for headaches, and three times less likely to receive imaging than white children. #Headaches are vastly undertreated among racial and socioeconomic groups . . .
— @migraine_ce (@migraine_ce) October 26, 2021
9) See ICHD3 for #Pediatric Migraine Criteria @JCephalalgia 2018 @ihs_official Headache attacks shorter than in adults (kids-2-72 h, adults- 4-72 h), headache is more often bilateral in children. Bring the knowledge to help the kids! @AANmember @AHSheadache pic.twitter.com/fzoWVVS6bR
— @migraine_ce (@migraine_ce) October 26, 2021
11) Practice guideline update summary: Acute treatment of #migraine in children and adolescents @aanmember @ahsheadache: There is evidence to support use of ibuprofen, acetaminophen (in children & adolescents), & triptans (mainly in adolescents) https://t.co/ItBPjH7v9M
— @migraine_ce (@migraine_ce) October 26, 2021
13) And prophylactic measures for #Migraine are important. @AANmember guidelines include “insufficient evidence to determine if children & adolescents receiving divalproex, onabotulinumtoxinA, amitriptyline, nimodipine, or flunarizine are …
— @migraine_ce (@migraine_ce) October 26, 2021
15) Children & adolescents receiving topiramate and cinnarizine are probably more likely than those receiving placebo to have a ⬇️in headache frequency. Children w/migraine receiving amitriptyline + cognitive behavioral therapy are more likely than those …
— @migraine_ce (@migraine_ce) October 26, 2021
17) Oskoui et al. Neurology 2019;93:500: Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention, Report of the Guideline Development, Dissemination, & Implementation Subcommittee of the AAN and the AHShttps://t.co/f6uaPRPYik
— @migraine_ce (@migraine_ce) October 26, 2021
19) See Infographics from AHS for balanced treatment plans for kids https://t.co/Wqfze0SD03
Balanced Treatment Plans
• To achieve treatment goals, balanced treatment plans are needed
• Balanced plans include medical, biobehavioral, and nonpharmacologic treatments pic.twitter.com/zGg5m1KHpB— @migraine_ce (@migraine_ce) October 26, 2021
21) Please answer the quiz and join us tomorrow for more discussion and a case! @HeadacheMD @EhrlichNP @Rashmihalker @CSWhiteMD pic.twitter.com/3AaJq2MolV
— @migraine_ce (@migraine_ce) October 26, 2021
23) The answer to yesterday's quiz is “D”.
TMS, nVNS and REN device are FDA cleared for kids of 12 years of age and above for #management of #migraine pic.twitter.com/csP4ONZHNt— @migraine_ce (@migraine_ce) October 27, 2021
25) Remember to use SNOOP mnemonic (now SNOOP4) & rule out secondary headache in older adults! Identify red flags that require further investigation: systemic symptoms, secondary risk factors, neurologic exam, onset (sudden, thunderclap), older patient …
— @migraine_ce (@migraine_ce) October 27, 2021
27) Do not forget to rule out temporal arteritis #GCA (giant cell arteritis) in older adult with headache. Lab work includes ESR, CRP in patients with signs of TA such as jaw claudication, vision changes. Consider temporal artery biopsy when suspicion of GCA is higher.
— @migraine_ce (@migraine_ce) October 27, 2021
29) So, here’s our case of the day!
67F presents for #Headache clinic follow up. She has history of migraine, treated successfully w/Rizatriptan 10 mg acutely. She inquiries about new meds for “as needed” headache management which do not narrow vessels. She also has …— @migraine_ce (@migraine_ce) October 27, 2021
31) You tell her about Lasmiditan, an FDA approved ditan, selective agonist of 5-HT 1F receptor, which also do not constrict blood vessels.
— @migraine_ce (@migraine_ce) October 27, 2021
33) She also wants to learn more about preventive meds. You discuss behavioral modalities and lifestyle mods. The best course of action for preventive meds can be stated as: “start low and go slow”.
— @migraine_ce (@migraine_ce) October 27, 2021
35) Be sure to return TOMORROW to wrap up this case and earn your CE/#CME credit! @Neuralgroover @thedizzydoc @Neurotweeps @HindiyehNada @RKrel @RRaoMD @NithiAnandMD @okheadachedr @EHF_Official @Neurology_JC @SocBlackNeuro @WillSKingston @ClintLauritsen @medinmanhattan pic.twitter.com/haPJa0VYno
— @migraine_ce (@migraine_ce) October 27, 2021
37) … although we know that effects of the drug on the immune system are longer acting than this. Knowing a drug's half-life can be useful when discussing switching treatment or family planning.https://t.co/XOsOC6PtCv pic.twitter.com/o7IllAdAm8
— MultipleSclerosis_CME (@ms_cme) October 27, 2021
39) In this regard, it is particularly helpful to understand DMT drug elimination half-life. Drugs with a longer half-life will take longer to clear prior to conception. Useful guidance can be found at:https://t.co/TW0zcOC5OB
— MultipleSclerosis_CME (@ms_cme) October 27, 2021
41) And please continue your education on #pharmacists improving #MS care by reading:
—https://t.co/saBvc7Osed
—https://t.co/goWMoG8ZvR
—https://t.co/BdNN8MGsY3
—https://t.co/PboP6kQwBH pic.twitter.com/fv5Mwglas3— MultipleSclerosis_CME (@ms_cme) October 27, 2021
42) And with that, I bid you farewell and best wishes in managing your #PwMS. This is @RayDorsey7 and @SKriegerMD and I hope that you FOLLOW US for more education on managing #multiplesclerosis. And right now you can claim your CE/#CME credit at https://t.co/Niw2CANeRj
— MultipleSclerosis_CME (@ms_cme) October 27, 2021
